Is dysfunction of the tissue plasminogen activator (tPA)-plasmin pathway a link between major depression and cardiovascular disease?

Hou, Sheue-Jane; Yen, Feng-Chang; Tsai, Shih‐Jen

doi:10.1016/j.mehy.2008.09.009

Cited by 19 publications

(16 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An association between BDNF and depression has been demonstrated in clinical and animal studies. Animal and human studies have revealed that BDNF may play an important role in the pathogenesis of depression and, therefore, might be involved in the therapeutic effects of antidepressants (59). Animal experiments have demonstrated that decreases in BDNF were associated with depressive states, and clinical studies have shown that administration of BDNF can reverse these states (60).…”

Section: Discussionmentioning

confidence: 99%

Depression and Risk for Diabetes: A Meta-Analysis

Zhang

et al. 2015

Canadian Journal of Diabetes

200

119

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Depression and Risk for Diabetes: A Meta-Analysis

Zhang

et al. 2015

Canadian Journal of Diabetes

200

119

View full text Add to dashboard Cite

“…131 tPA is a thrombolytic enzyme, with neuroplastic and apoptotic functions in the brain. 132 Its expression is upregulated in stress, 133 and low levels of tPA have been found in depressed patients.…”

Section: Discussionmentioning

confidence: 99%

Pathophysiological basis of cardiovascular disease and depression: a chicken-and-egg dilemma

Paz-Filho

Licinio

Wong

2010

Rev. Bras. Psiquiatr.

View full text Add to dashboard Cite

Objective To describe the pathophysiological basis linking cardiovascular disease (CVD) and depression; to discuss the causal relationship between them, and to review the effects of antidepressant treatment on cardiovascular disease. Method A review of the literature based on the PubMed database. Discussion Depression and cardiovascular disease are both highly prevalent. Several studies have shown that the two are closely related. They share common pathophysiological etiologies or co-morbidities, such as alterations in the hypothalamic-pituitary axis, cardiac rhythm disturbances, and hemorheologic, inflammatory and serotoninergic changes. Furthermore, antidepressant treatment is associated with worse cardiac outcomes (in case of tricyclics), which are not observed with selective serotonin reuptake inhibitors. Conclusion Although there is a strong association between depression and cardiovascular disease, it is still unclear whether depression is actually a causal factor for CVD, or is a mere consequence, or whether both conditions share a common pathophysiological etiology. Nevertheless, both conditions must be treated concomitantly. Drugs other than tricyclics must be used, when needed, to treat the underlying depression and not as mere prophylactic of cardiac outcomes.

show abstract

“…55 Recently, it has been hypothesized that variations of tissue-type plasminogen activator (tPA) and its inhibitor plasminogen activator inhibitor-1 (PAI-1), both widely expressed in the brain, might be related to stress reaction and depression and thus provide a further plausible link between major depressive disorders and CVD. 56 Previous epidemiologic investigations have shown that both male and female patients with mental depression have higher PAI-1 levels than those of healthy controls. 57,58 Moreover, in the brain, t-PA has been implicated in the cleavage of proBDNF (brainderived neurotrophic factor) to BDNF, a peptide whose role in the pathogenesis of mental depression is now well established.…”

Section: Hypercoagulable Statementioning

confidence: 98%

“…Additional to the role of fibrinolysis in the pathogenesis of mental depression, the above might also reflect therapeutic potential, as targeting of the fibrinolytic system, namely the t-PA/PAI-1 pathway, with specific drugs could ease the treatment of patients with both CVD and mental depression. 56 Platelet Activation Increased platelet reactivity has been suggested as a mechanism by which depression increases adverse cardiovascular events in CAD patients. 61 Both baseline platelet activation and responsiveness might be increased in depressed patients.…”

Section: Hypercoagulable Statementioning

confidence: 99%

Mental Depression and Cardiovascular Disease: A Multifaceted, Bidirectional Association

Lippi

Montagnana

Favaloro

et al. 2009

Semin Thromb Hemost

135

View full text Add to dashboard Cite

The association between cardiovascular disease and mental depression is multifaceted and likely bidirectional. Depressed patients are at significantly higher risk for cardiac morbidity and mortality even in the absence of a diagnosis of major depression, whereas mental depression is nearly 3 times more frequent in patients after an acute myocardial infarction and contributes to a worse prognosis. Therefore, depressed patients might become trapped in a harmful loop, where mental symptoms might be worsened by the synergistic effects of stress and cardiovascular risk factors, and where they are otherwise vulnerable to acute cardiovascular events due to the synergistic effects of mental stress and an underlying atherothrombotic disorder. Although the exact pathway(s) underlying the interplay between depression and cardiovascular disease remains to be elucidated, the mechanisms most often implicated include hormonal variations, metabolic abnormalities, hypercoagulability, increased platelet aggregation, inflammation, and endothelial dysfunction. This article aims to review the biological and clinical links between depression and cardiovascular disease.

show abstract

Is dysfunction of the tissue plasminogen activator (tPA)-plasmin pathway a link between major depression and cardiovascular disease?

Cited by 19 publications

References 38 publications

Depression and Risk for Diabetes: A Meta-Analysis

Depression and Risk for Diabetes: A Meta-Analysis

Pathophysiological basis of cardiovascular disease and depression: a chicken-and-egg dilemma

Mental Depression and Cardiovascular Disease: A Multifaceted, Bidirectional Association

Contact Info

Product

Resources

About